(Published in NUS Dentistry 2022 Annual Report)
In June 2022, the Faculty, in collaboration with the National University Centre for Oral Health Singapore (NUCOHS), set up the first tooth bank in Singapore - the NUCOHS Tooth Tissue Bank (NTTB). The NTTB is an enterprise that will facilitate research initiatives in an integrated academic health system and help to maintain a ready supply of donated teeth so researchers can tap on them for further studies to benefit oral health globally.
Managed by the Faculty’s Clinical Research Unit (CRU), the team collects donated extracted teeth daily. CRU removes blood, dental plaque and calculus from the donated teeth, and disinfects them before committing them to long-term storage. The team also reviews research studies which require teeth samples and manages the inventory. Associate Professor Vinicius Rosa, Vice Dean (Research), shares more on the NTTB and how it will benefit research as well as impact oral and systemic health.
What inspired the Faculty to develop Singapore’s first tooth tissue bank?
Assoc Prof Rosa: We were inspired to start NTTB because we wanted to support our researchers in their studies so that, as a Faculty, we could be more productive in our research and strive for more impactful outcomes. Before the Bank was established, collecting clinical samples to start and maintain projects was challenging. We thus wanted to create a new model where we could have biological materials readily available for use in studies. By reducing time spent gathering materials, we allow our researchers to focus more on their research approach, design and discoveries. “We were inspired to start NTTB because we wanted to support our researchers in their studies so that, as a Faculty, we could be more productive in our research and strive for more impactful outcomes.”
What is tooth tissue banking about and what are the processes for banking?
Assoc Prof Rosa: Tooth tissue banking is about collecting, processing and storing teeth and other dental tissues so that they are readily available for researchers when needed. First off, we engage and encourage patients who undergo tooth extractions to donate their extracted tooth by way of collection kits which we distribute to clinics in NUCOHS. The kits are then collected and the teeth are cleaned, sorted and placed inside containers with solutions to preserve their biological integrity. Based on the most optimal ethical standards, we have also created processes, such as internal and external audits, to ensure that every tooth is accounted for.
Describe the work that went behind setting up the Bank.
Assoc Prof Rosa: The preparations were extensive. Firstly, we needed to deliberate on the ethical and safety considerations behind the banking processes and assess the risk of sustaining the Bank. Then we had to apply to set up a tissue repository and clear the regulatory processes to start the Bank. Necessary equipment to ensure the safe and optimal banking of the teeth was then purchased. We also wrote procedures so the public could understand how to store their teeth with us. Lastly, we commenced training for specialised staff to operationalise the Bank and we engaged patient-facing clinicians and staff on how to obtain consent for tooth donation.
What are the challenges you think the team will face for tooth banking and how do you hope to overcome them?
Assoc Prof Rosa: With the launch of the Bank, there is a need for us to encourage members of the public to donate their teeth. This means that we ought to increase awareness of how donating and collecting teeth could positively impact dentistry and patients’ overall well-being. Since the concept of tooth banking is new in Singapore, it will take time for people to fully understand the impact that their seemingly small actions have. For the Bank to grow, we will need to work towards making tooth donation a natural process when patients extract their teeth in clinics. But I do not consider this a challenge. Instead, I see it as a positive change that we aim to bring about through the tooth bank. We hope that by boosting a culture of biological material donations (like tooth donations), we can eventually work towards supporting and advancing research efforts to yield innovative healthcare solutions.
How will the Bank benefit research and, most importantly, go beyond to impact oral well-being and overall health globally?
Assoc Prof Rosa: Through research, we seek to use donated teeth to understand how materials and bacteria interact. Growing a tooth library will enhance the study of this process in the laboratories, leading to improved preventive and curative strategies for caries and gum diseases, for instance. Using donated teeth, we can also build our knowledge about pulp regeneration, adhesion of dental materials to teeth and the degradation of hard tissues. Such knowledge will shed light on new alternatives to sustain the vitality of pulp tissues and promote its regeneration. Moreover, studying the tooth out of the mouth will help us to generate essential solutions to questions which remain open in dental research. With more research, we can create new and significant knowledge to benefit oral and systemic health in the long run. This continues to excite and motivate the Faculty to develop the tooth bank to its total capacity!
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